Multiples

Several times per year, NMAC requires that all counseling volunteers attend a study night to stay current with breastfeeding issues. During our most recent study night, the topic of “breastfeeding multiples” was presented by two lactation consultants from the Breastfeeding Resource Center in Glenside, PA. Below are the notes taken during that session. (Support group for moms of multiples – www.bucksmontmoms.org)

How do you determine the correct size of the breast shield (flange) on the pump?
If it is painful, this is a sign that the woman is using the wrong size. Pumps come with a standard size breast shield (flange) and several other sizes are available. The nipple shouldn’t be “smashed” into it, it should be comfortable and some breast tissue with the nipple should be pulled in to the shield (flange).

Do mothers of multiples need nipple shields more often than mothers of single babies?
It depends, but when a baby is in the NICU, hospital staff give the mom a nipple shield automatically, whether or not she needs it.

Does the size of a nipple shield correlate with the size of the breast shield (flange)?
There is no correlation.

Is there a correlation between a woman’s breast size and nipple size?
There is no correlation.

Is there a difference between the effectiveness of a standard breast pump vs. a hospital grade pump?
It depends on the specific situation. A mother of a NICU baby should still use the hospital grade pump. For the mother of a 37 week baby who is nursing pretty well, a standard breast pump would probably be ok.

How do you get multiple babies on the same feeding schedule?
You wake the other baby up when the first one wants to feed. You force them on to the same feeding schedule.

How many more calories does a mom of multiples need?
She will naturally want to eat more. The guideline is to eat to hunger and drink to thirst.

Are the hospital staff in this area supportive of kangaroo care (skin-to-skin contact)?
Yes, because there is no research that shows anything bad can happen from kangaroo care.

Can kangaroo care be done with the baby’s father?
Kangaroo care with the father is also beneficial. Only the mother, though, can regulate the baby’s temperature. Anyone can participate in kangaroo care and it’s beneficial.

What community supports are available for mothers of multiples?
The Bucks/Mont mothers of multiples group, bucksmontmoms.org.

How does the mom handle partial breastfeeding?
If the babies get one bottle per day, the mom’s milk supply should still be ok and she doesn’t have to pump. If the babies get more than one bottle per day the mom should pump during these feedings in order to maintain her milk supply.

What is the best nursing position for twins?
The double football hold, because it is the only nursing position that you can do simultaneously long-term.

Should premature multiples be given pacifiers?
Pacifiers benefit premature babies. They help to comfort babies and help with their growth. Pacifiers also help with the transition to the breast.

When should mothers stop supplementation?
It’s best to taper off and not stop supplementation completely all at once (once a pediatrician has said it is ok to stop the supplementation because the weight gain is good).